Remote Strategic Pricing Operations Manager

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Posted a day ago United States Salary undisclosed
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Job Description

One of our Pharmacy Benefit Management companies is actively hiring for a Strategic Pricing Operations Manager to join the team. The Manager of Strategic Pricing Operations will build and maintain generic MAC lists to meet contractual obligations to clients and pharmacies while maintaining the exceptional level of professionalism and customer service standards that the client has attained within the prescription benefit management (PBM) industry. This position has 2 direct reports. Responsibilities include:



-Provide analytic support including the tracking and forecasting of utilization patterns across plans and pharmacies

- Manage and assist with development for the following objectives:

- Retail and mail order Maximum Allowable Cost (MAC) drug price development and ongoing management of MAC lists and MAC guardrails

- Retail pharmacy contract compliance

- Retail pharmacy MAC appeals tracking and response management

- Retail pharmacy utilization reporting for the Provider Relations team

- Research new-to-market drugs and brand drug patent-expirations

- Research and forecast estimates of drug acquisition costs and recommend pricing adjustments

- Manage the additions and deletions of drugs and other changes to Medispan and First Data Bank, and other drug databases

- Implement individual MAC price changes within MAC lists

- Implement MAC list changes for pharmacies and/or clients

- Report the impact of all pricing strategies utilized by the Pricing Team



-Manage the creation, documentation and communication of team policies and procedures

- Make contract modification recommendations to the Companys Senior Management team and Provider Relations team

- Meet with retail pharmacy chains representatives to exchange, present, and discuss contract compliance reports and research differences until agreement is reached

- Manage ad-hoc analyses in support of the Request for Proposal (RFP) process for complex proposals

- Conduct and/or report on special studies, investigations, pricing trends and forecasts


Pharmacy Benefit Management or Healthcare Insurance

Masters Degree

Management experience

Pharmacy Claims Experience

MS Access and SQL programming knowledge
Bachelors degree in business, mathematical, statistical, financial, or applied science discipline strongly preferred; proven industry experience will be acceptable in lieu of degree

Minimum 5 to 10 years relevant pricing or finance experience, preferably with a Pharmacy Benefit Management or Healthcare Insurance

Financial and statistical reporting knowledge

Expert in Excel

Intermediate in SQL